| Dr. George W. Jackson Pa | |
|
1440 Highway 62 412 Highland AR 72542-9497 | |
| (870) 856-6000 | |
| (870) 856-6001 |
| Full Name | Dr. George W. Jackson Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1440 Highway 62 412, Highland, Arkansas |
| Authorized Official Name and Position | Cary Jackson (BUSINESS MANAGER) |
| Authorized Official Contact | 8708566000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. George W. Jackson Pa 1440 Highway 62 412 Highland AR 72542-9497 Ph: (870) 856-6000 | Dr. George W. Jackson Pa 1440 Highway 62 412 Highland AR 72542-9497 Ph: (870) 856-6000 |
| NPI Number | 1598980229 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 04/27/2009 |
| Medicare PECOS PAC ID | 0143378208 |
|---|---|
| Medicare Enrollment ID | O20090429000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598980229 | NPI | - | NPPES |
| 142802002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MC1251 (Arkansas) | Primary |
| Provider Name | George W Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497824304 PECOS PAC ID: 8123003571 Enrollment ID: I20040621001335 |
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